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Kaiser nurses say AI, surveillance are making their jobs and patient care worse

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Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#171

Post by Loughla »

xmprt wrote: post #105
abeindoria wrote: post #100

That is surprising. My primary care provider had a different response. Basically he said something in line of "You wouldn't believe how much of a relief it has been. In your last visit, you saw me typing everything you were saying, right? I don't have to. I can listen to you and take very specific notes as necessary as opposed to focusing on both typing and listening to you at the same time. It has bought my stress l…

Nursing and PCP are very different jobs. Ones a lot more cognitive than the other whereas the other involves actually doing/executing on a plan. I can see how AI would help reduce the cognitive burden while actually increase stress on the execution side.

Do you still get doctors for primary care? Our local hospital is hiring nothing but nurse practitioners now.

They're amazing in a support role, but not equipped as well for primary care roles.

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#172

Post by ak217 »

drknownuffin wrote: post #154
ak217 wrote: post #94

Earlier quoted context omitted.

Yeah, this whole discussion cracks me up. I have a number of direct experiences with Kaiser nurses. They repeatedly got into arguments with doctors in front of me, tried to countermand doctors' instructions, ignored their patients, and complained to each other about their patients while they were right there. Repeated unprofessional behavior with no discernible change after trying to address it. My take is that the K…

To one degree or another, this is endemic among nurses. It's part of a broader cultural element: nursing programs have entrenched a culture of nurses vs. doctors. There are literally questions on their licensing exam to the effect of "which of these orders from a doctor should you refuse to enact?" (rather than, say, "which of these orders should you contact the doctor to seek clarification on?" or some other collabo…

I agree (with the obvious qualification that there are excellent nurses out there who do a great job and don't let this stuff get in the way of helping their patients, some Kaiser nurses included). But I also see a marked difference in behavior and outcomes in other hospitals I've been to. Yes, there are still some unprofessional nurses in those networks as well, but judging by the outcomes, the hospitals don't let them do damage.

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#173

Post by Quekid5 »

markdown wrote: post #117
datsci_est_2015 wrote: post #65

Earlier quoted context omitted.

Patients are not customers, or at least I don’t want to live in a world where patients are considered customers. Customers and vendors are usually more of a symmetric relationship: price transparency, alternatives, lack of urgency. These are all characteristics of transactions that healthcare often lacks.

If the hospital is owned by private equity, the owners definitely think of the patients as customers. Doctors and nurses shouldn't, but the owners do.

Lack of empathy tends to trickle down, alas.

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#174

Post by zx8080 »

insane_dreamer wrote: post #109
9x39 wrote: post #74

It sucks because AI reduces call center costs in many toil tasks very effectively, regardless of whether you want to help or dissuade customers - it's just well-suited to the task and it's going to accelerate. It's a win for capital and the technology implementers, even if it's a loser for the call center employees and callers. Some of the tech is pretty scary. One big vendor's solution [0] can provide not just AI ag…

so far, almost always when I get an AI responder I find it useless and basically try to get to a human as quickly as possible if it was easy enough for an AI responder to solve I would have solved it myself

> if it was easy enough for an AI responder to solve I would have solved it myself

Hey, company's AI can help a lot in stealing its service's user passwords, which you usually cannot do yourself _that_ easy:

https://news.ycombinator.com/item?id=48350239

Think of AI as a tool... for data leaks. (not 100% sarcasm)

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#175

Post by pstuart »

inigyou wrote: post #130
pstuart wrote: post #126

Earlier quoted context omitted.

If you're going to play the "both sides are the same" game you need to be more precise in what that means. DNC is absolutely subservient to their patrons and party leadership in general owned by the donor class. But the similarities stop there. The party platforms are in stark difference, and the GOP is now literally a cult of personality run by a mob boss. The naked corruption is off the charts. In fact right now Tr…

On this particular issue both sides are identical. On other issues they are not.

On corporate whoredom? Absolutely.

My pushback is that now is not the time for both-sides-ism. It needs to be addressed but most voters are poorly informed or vote their emotions and that talking point needs to go in the back pocket for later, if there is one.

I get your point, and the other one stating that Democrats are not "the left", but they are the the least worst option that a 2 party system offers.

The game is rigged, but this quote nails it:

On Undecided Voter s: "To put them in perspective, I think of being on an airplane. The flight attendant comes down the aisle with her food cart and, eventually, parks it beside my seat. “Can I inter est you in the chick en? ” she asks. “Or would you prefer the platter of shit with bits of broke n glass in it?”

To be undecided in this elect ion is to pause for a moment and then ask how the chick en is cooked.” ― David Sedaris

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#176

Post by inigyou »

tomjakubowski wrote: post #157
inigyou wrote: post #23

Earlier quoted context omitted.

Isn't that the insurance company whose CEO was murdered because of the terrible quality of care they delivered?

Mangione had back issues and apparently some difficulty in getting treatment for it, but he wasn't insured by UHC. According to his manifesto, he chose Brian Thompson as his victim because UHC was the largest health insurance company in the United States.

His alleged* manifesto. There is no reliable evidence that Luigi Mangione committed any crime. It seems more likely that Brian Thompson was killed by a disgruntled customer.

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#177

Post by Quarrelsome »

derekdahmer wrote: post #115

I RFTA and the majority of the complaints are about call center metrics and the pressure to ration care. These are real concerns about misuse of metrics, but not AI. The AI empathy thing was a 2024 pilot that was discontinued. FWIW my wife works for Kaiser and finds a lot of value in the the medical LLM tools available to her. She tells me being able to do live translation, summarize notes, and quickly get comprehens…

everyone is very thirsty for AI hate, so its not unexpected. Today its a mixed bag of corpo hate, anxiety about the future, inequality and traditional class warfare, combined with the typical technical ignorance.

I would expect companies to blend shit metrics with AI systems, if not at Kaiser then at other places. People lack imagination and using AI to monitor your workforce has to be one of the possibly worst ways to use it. Alternatively some dickhead will "lean startup" their way into measuring "performance" in such a way with the "help" of AI that they will do something even worse.

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#178

Post by segfault99 »

Workplace metrics and surveillance... What could possibly go wrong?

That being said, more than one (female at that) doctor has told me in confidence and based upon their observations during residencies, etc. that if I'm ever admitted, be very careful how I modulate my interactions with nurses. They're not all Florence Nightingale and Mother Theresa and there exist those who will @#$% you up on various pretexts or are just plain sloppy and negligent.

Despite all the moralising fluff, it's just a job, not some saintly vocation. Some safety oversight is needed, just as it is for any other work function. Still, can bet that anything 'Corporate' has mandated will be Goodharted up the wazoo.

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#179

Post by gusgus01 »

weard_beard wrote: post #76
ImPostingOnHN wrote: post #16

Earlier quoted context omitted.

Not asking the customer because you're afraid they'll tell you they're upset is a good indicator that you should do it more, and fix the issues. You can ask the customer enough times that unreasonable customers or surveys are averaged out. A good question might be "why are you upset?"

Isn’t it a running joke at this point that if you do what customers ask instead of focusing on the highest quality of service you get worse outcomes and the customer is still unhappy?

I thought that was more about correctly interpreting their asks, and not just actioning without consideration. If all your customers are saying your chair could use a cushion, it doesn't mean add a cushion, it means the chair is uncomfortable and you need to investigate why.

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#180

Post by bevr1337 »

ai_fry_ur_brain wrote: post #153
derekdahmer wrote: post #115

I RFTA and the majority of the complaints are about call center metrics and the pressure to ration care. These are real concerns about misuse of metrics, but not AI. The AI empathy thing was a 2024 pilot that was discontinued. FWIW my wife works for Kaiser and finds a lot of value in the the medical LLM tools available to her. She tells me being able to do live translation, summarize notes, and quickly get comprehens…

I personally will not use a provider who uses llm tools. I know it makes me and my coworkers less careful and lazier. Qualities I dont want in a health care providor. Ive actually moved primary care physicians over this once already, found the oldest guy I could who barely knows how to use a laptop but spends a bunch of extra time with me.

My current provider shows me their computer monitor for the entire appointment. I didn’t ask for that treatment but I really appreciate it.
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